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Understanding Carbohydrate Impact on Diabetes Management


Updated December 23, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

There is a lot we know about type 2 diabetes management, much of which comes down to diet. Now, if you've just recently been diagnosed with diabetes, the extent to which eating right plays a part in your health may be a bit unfamiliar. Understanding a bit more about blood sugar, and how carbohydrates can impact it, is a good start in schooling yourself on the diet-related ins and outs of your condition.

Why Blood Sugar is Elevated with Type 2 Diabetes

Type 2 diabetes is characterized by high blood glucose, what most people simply refer to as blood sugar.

Insulin, a hormone that takes glucose out of the blood and moves it into body cells where it can then be used for energy, is not used properly by the body's cells and/or is not produced in enough quantity to overcome cells' resistance to its actions (insulin resistance).

This is the hallmark of diabetes and what causes glucose to build up in the blood.

Why it Matters if Blood Sugar Is Elevated

In the short term, high blood sugar levels can make you feel very hungry because your cells are not getting enough energy. They can also cause increased urination and thirst; the extra sugar in the blood finds its way into urine, pulling water with it. In addition, you may notice blurred vision, fatigue, dry mouth, weight loss, poor wound healing, or recurrent infections.

Over time, high levels of glucose in the blood can cause several more severe issues, including blindness; kidney failure; foot ulcers that lead to amputations; paralysis of the stomach; chronic diarrhea; the inability to control heart rate and blood pressure; and accelerated plaque deposits in arteries, which can lead to increased risk of heart attack and stroke.

How Carbohydrates Impact Blood Sugar

Starches are the carb sources we typically think of. They provide a lot of energy, and they will have an impact on blood sugar levels. However, they require some digestion before any of that can happen. The chewing of food, the contractions of the intestines, and the enzymes secreted by the body all help in this effort.

Foods in this category include examples such as cereals, grains, pasta, breads, crackers, starchy vegetables, cooked beans and lentils. The goal of this digestion is to break the carbohydrates down into one-molecule sugars.

But there are other carbs in our diets, known as simple carbohydrates. They include 6 types sugars that are found in fruit, honey, milk and table sugar. These are either two- or one-molecule sugars, and they require less effort to be used by the body.

Once carbohydrate is adequately broken down, it can be taken up by the blood stream. Usually, insulin transports these simple sugars across the walls of body cells where it can then be used for energy.

This is where the problem lies when you have type 2 diabetes: The insulin process does not work like it is supposed to (or at all), so the simple one-molecule sugars build up in the blood stream. When you check your levels of blood glucose, they will be high.

For some people with type 2 diabetes, counting carbohydrates and following a meal plan and exercise program will be enough to control blood sugar levels and manage all of the symptoms of diabetes.

For others, medication will be necessary to keep things under control. But take note that simply 'popping a pill' is not enough. Diabetes medications may be in the form of insulin itself, or may be a type of medication that helps insulin work properly. Either way, diet is a key element -- if you take medication without the right amount of carbohydrate, you will end up with high or even low blood sugar.

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